[26F] With chest and back pain, rash with blisters, and recent infections

Patient Description

A 26-year-old female presents with sudden onset of severe chest and back pain, rated 9 out of 10, persisting for two days. The pain is throbbing and worsens with movement or straining. Additionally, the patient has developed a rash with blisters on the right wrist and upper thighs. Three days prior, the patient experienced a sore throat and a kidney infection with a 1 mm stone. The patient has a history of Crohn's disease and lupus, diagnosed at age 9, and reports significant recent stress. No current medications for these conditions are being taken, and the patient has an allergy to Imuran. The patient has not had chickenpox, nor been vaccinated against it, and has no history of shingles or similar rashes. The patient has not been in contact with anyone with a viral infection recently.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, there are a few possibilities to consider:

  1. Shingles (Herpes Zoster): Given your rash with blisters and the sudden onset of severe chest and back pain, shingles could be a possibility. Shingles is caused by the reactivation of the chickenpox virus and can cause a painful rash and nerve pain. It is more common in individuals with weakened immune systems, such as those with lupus or Crohn's disease.

  2. Lupus Flare: Your history of lupus, combined with stress, could be contributing to a lupus flare. Lupus can cause a wide range of symptoms, including rashes, joint pain, fatigue, and headaches.

  3. Crohn's Disease Complications: While less likely to cause a rash, Crohn's disease can lead to systemic symptoms like fatigue and could potentially contribute to your current condition.

It's important to consult with a healthcare professional for a proper diagnosis and treatment plan. They may recommend antiviral medications if shingles is suspected or adjust your treatment plan for lupus or Crohn's disease.

What you can do

Chest and Back Pain:

  • Seek medical attention promptly, especially given the severity of your pain. A healthcare provider can evaluate your symptoms and determine if antiviral treatment is needed.
  • Over-the-counter pain relief, such as acetaminophen or ibuprofen, may help manage pain, but consult with a healthcare provider before taking any medication.

Rash with Blisters:

  • Keep the rash clean and dry. Avoid scratching to prevent infection.
  • A healthcare provider may prescribe antiviral medications if shingles is diagnosed.

Headaches and Fatigue:

  • Ensure you are staying hydrated and getting adequate rest.
  • Consider stress-reduction techniques such as deep breathing exercises or meditation.

General Health:

  • Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider. This can help in managing your chronic conditions and any new symptoms.

What you should look out for

  • If you experience any new or worsening symptoms, such as difficulty breathing, chest tightness, or spreading of the rash, seek medical attention immediately.
  • Monitor for signs of infection, such as increased redness, swelling, or pus from the rash.
  • Keep an eye on your overall health and any changes in your chronic conditions, and communicate these to your healthcare provider.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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4 d ago

People Also Ask

What are the common symptoms of shingles and how is it treated?

Shingles typically presents with a painful rash that develops into blisters, often on one side of the body. It can also cause nerve pain, fever, and fatigue. Treatment usually involves antiviral medications to reduce the severity and duration of the symptoms, along with pain relief measures.

How can stress impact lupus and potentially trigger a flare-up?

Stress can exacerbate lupus symptoms and trigger a flare-up, leading to increased joint pain, fatigue, rashes, and other systemic symptoms. Managing stress through relaxation techniques, adequate rest, and a healthy lifestyle can help mitigate these effects.

What are the potential complications of Crohn's disease that could relate to my symptoms?

Crohn's disease can lead to systemic symptoms such as fatigue, weight loss, and nutritional deficiencies. It can also cause complications like strictures, fistulas, and increased risk of infections, which might contribute to overall health issues.

What precautions should I take if I have a rash with blisters and suspect it might be shingles?

If you suspect shingles, keep the rash clean and dry, avoid scratching, and seek medical advice promptly. Antiviral medications can be prescribed to help manage the condition. It's also important to avoid contact with individuals who have not had chickenpox or the vaccine, as shingles can spread the virus.

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